It's Important to Take Care of Yourself Too

I am noticed that many of the teenagers that I work with do not consider themselves to be important. Instead they value what other people think about them more than what they think about themselves.  This leads to a very dangerous situation where teenagers are willing to do whatever their friends tell them to in order to be excepted.

Besides putting a teenager at risk for experimenting with drugs or alcohol.  It also sets up a situation for when teenagers get older and are in relationships they don't value themselves and they are in danger of being in abusive relationships. Furthermore, besides the risk of being in a an abusive relationship they may not know how to get out of the relationship because they do not value themselves.

I read an article about How to value yourself and the article states the facts very simply and clearly. I have attached a link to this article so you can read it and hopefully discuss this issue with your teenagers and let them know how important they are and how important it is that they value themselves too.

A very important concept that many of us need to learn 4 Steps To Putting Yourself First http://blogs.psychcentral.com/childhood-neglect/2017/02/4-steps-to-putting-yourself-first/#.WJzibMepSWs.twitter

Dr Michael Rubino has been working with children and teenagers for over 20 years. For more information about his work or his private practice visit website at www.rubinocounseling.com

Pink is Here! Parents here are the facts

Parents this is a follow up on an article I wrote about the drug Pink.  This drug is in the San Francisco Bay Area. I hear teenagers mention it to me.  Also if I try to warn teenagers about this drug, I hear them tell me that they already know about it. So parents please pay attention to the following information.

Therefore,  the name you need to know right now is Pink.  This is the street name of a new synthetic drug being used by teenagers and college students.  The legal name for this drug is U4.  The DEA of the United States has banned the sale of this drug in all 50 states.  However, the drug is still for sale on the internet.  It is being sold by companies in China and it is being sold at a very cheap price.  Therefore, teenagers can get it very easily.

This drug is twice as strong and heroin and seven times as strong as morphine.  People often die the first time they use it.  So far 100 deaths in the U.S. have been linked to Pink.  It is currently mainly on the east coast but it is spreading across the country very quickly.

The drug comes in a white powder.  Many teens assume they can use the same amount as if they were using morphine or heroin.  However, this assumption is wrong.  The drug is so deadly that the amount equivalent to a few grains of sand can kill someone.  They call it Pink because teenagers typically snort it off their pinky. Teenagers who are buying this drug online often ignore the warning on the website that this drug is not for human consumption.

The DEA became aware of the drug two years ago and put a temporary ban on it.  Now after further studies they have banned the sale of U4 or the street name for the drug, Pink, in all 50 states.  Remember this drug is twice as strong as heroin and seven times as strong as morphine.  We already have an epidemic of accidental overdosages from heroin in the U.S.  The CDC estimated that in 2014 there were 50,000 deaths due to accidental heroin overdosages and a majority of these deaths were teenagers.  Furthermore, the CDC statistics show a 62% increase over the past ten years in the number of accidental heroin deaths.  Again most of the deaths are teenagers and children as young as 12 years old.  Pink has the possibility to be far more devastating than any other drug.

As parents you need to go online and educate yourself about this drug.  You also need to educate your teenagers and children in college about how dangerous this drug is in reality.  Maybe they have already used it and nothing happened so they think people are exaggerating how dangerous this drug can be.  However, this is the point you really need to understand this drug comes as a powder and using the amount of one grain of sand too much can kill.  There is no way to tell if you have too much on your pinky.  Also since it is very new, we do not know the long term effects of this drug.

So again as parents educate your children about this drug and point out it states not for human use on many of the websites.  Also if you notice any packages or bank charges by your teenager for buying items in China, check it out.  This drug is not for sale in this country and the main way that people are obtaining it is via the internet from companies in China who still sell this drug.

Dr. Michael Rubino specializes in treating high risk teenagers.  Those are teens who are suicidal, engage in cutting and drug use.  These are a few examples but he is also an expert in providing psychotherapy to children and teenagers in general.  For more information regarding his work or private visit his website at www.RubinoCounseling.com  or follow him on Twitter @RubinoTherapy.

Teens Domestic Violence & the Super Bowl

This weekend is the Super Bowl.  Many people look forward to Super Bowl parties and having a fun weekend.  However, it is not a fun weekend for everyone. For many it is a weekend of terror.

Because people tend to drink more alcohol at the parties this can raise tension between people. The result can be violence. In fact some statistics rate Super Bowl Sunday as the day of the year that the most domestic violence occurs.  It is serious enough that the NFL has started running PSAs regarding domestic violence.

To get a better idea click this link http://jezebel.com/the-super-bowl-domestic-violence-ad-was-a-real-woman-ca-1683220170 and read the statistics and watch the PSA.

The other issue is that children are exposed to the domestic violence which occurs on Super Bowl Sunday and the rest of the year.  This can have a serious impact on children.  They can grow up thinking it is acceptable to hit their partner or to be verbally abusive to their partner.  They may also grow up thinking that if they are hit by a boyfriend or girlfriend that they deserve it.  So they do not end the relationship or seek help because they believe the deserve to be abused.

Domestic Violence is a very complex problem that can go back many generations.  It can also be the source of bullying that we see at schools.  Therefore, domestic violence effects the entire family. It effects adults and children in very dramatic ways.

As I stated above, children who witnessed domestic violence are impacted by it too. Domestic violence occurs with teenagers too and is just as serious. Click this link and learn the shocking facts https://youtu.be/DdkTefhy6JM.

I encourage you to learn more about this issue and to talk to your teenagers about it.  No one has a right to hit them or to verbally tear them apart.

Dr. Michael Rubino specializes in treating children and adolescents and he is certified in the assessment and treatment of Domestic Violence. For more information about his work or private practice visit his website at www.rubinocounseling.com or follow him on Twitter @Rubinotherapy.

It's Prom - Here are Suggestions for Parents

Yes it is that time of year again — Prom Season. Along with the prom come the concerns of who will I go with? What will I wear? How much can I spend on a dress? And a number of other issues. Hopefully, you and your teen have already discussed the issues around dating and have agreements regarding dating. If not, Prom may be a harder issue because now you have to deal with issues regarding dating and Prom.

As a parent, the first thing to do is to contact your teen's High School and see what rules and guidelines the school has already established. Many High Schools have rules regarding who can attend, such as only students of that high school can attend, a dress code and some high schools require you to inform them if you are going and your date's name and the telephone numbers for both set of parents. They do this so if your teen fails to arrive by the designated time or if there are any problems at the Prom, they know who to call.

Another reason to contact the school is to find out where the Prom is being held. Due to the number of drunk driving deaths, deaths due to drugs and due to the costs being so high, a number of high schools have decide to have the entire Prom on the school campus. They serve dinner and have the dance at the school. Once you have the details then it is time to discuss with your teen what your expectations are regarding the Prom. This is also the time where you will set the rules for the Prom and make your agreements with your teen.

Assuming the Prom is not being held at the campus and instead being held at a Hotel, there are a few items to discuss. The first issue is price. Most teens want to go to an expensive dinner, hire a limo for the night and for the girls there is the Prom dress. I have seen teens spend over $2,000 on their Prom dresses.  A limo for the night can cost $800 and dinner can cost $200. If you have this money and are willing to indulge your teen then there is no problem. Most parents don't have this extra money so you need to agree on a budget. For example, a limo is not a necessity for the Prom. As a parent you may feel safer with a limo because your teen is not driving. Also there is a new law and limos cannot carry liquor when they are driving for Proms and they must card anyone consuming alcohol in the limo. You can bring the price down by having your teen split the cost of the car with 2 to 3 other couples. However, you will want to talk to the parents of your teen's date and any friends they are going with to ensure all the parents agree.

Another option is letting your teenager pay for part of their prom.  There is nothing wrong with expecting them to contribute to the limo, pay for the dinner and for girls, they can pay for part of their dress.  This is a good way to start teaching your teen about saving money and how much things really cost.

If you have a daughter you need to negotiate the cost of the dress or consider renting a dress. In my opinion she does not need to spend $500 on a dress or more to look good. The same rule goes for her hair. She does not need to spend $300 on styling her hair for one night.

You also need to talk with your teen regarding your expectations about consuming alcohol, using drugs and sexual activity on Prom night. Many teens plan After Parties for their Proms. Quite often at the After Parties is where the drinking, drug use or sexual activity occurs. This is another reason why it is important to know who your teen will be going with to the Prom and their parents. You should never allow your teen to go to an After Party where there is not adult supervision. If the party is at a friend's house with adult supervision and you have spoken with the adult, there should be no problem. If your teen wants to rent a hotel room so their date and their friends can have a party, this is a huge problem and should never be allowed.  There are too many incidents where teens overdose, drink to the point of alcohol poisoning, get pregnant or trash the hotel room. Most hotels will not rent a room to someone under 18, but many teens find away around this rule and some parents will rent the room for their teen. Another reason to know you teenagers friends and parents.

Another issue to discuss is curfew. Yes it is their Prom and you want them to have a good time, but there is no reason why they need to stay out the entire night or for the entire weekend.  If there is adult supervision the entire time it may work. If there is not adult supervision it is a recipe for disaster.

Finally, you need to have a discussion with your teen regarding acting responsibly and self-respect. The Prom is a major event and it is another step that your teen is taking into the adult world. They need to remember if they want to act like adults, they have to be willing to accept being treated like an adult. So if they violate the rules that their school has established for the Prom, they may be giving up their right to graduate with their class. The Prom should be a happy event that you and your teen both remember for a long time. If you discuss the issues before the Prom and come to agreements that you both accept then it should be a safe, happy event for all. Good luck!

Dr. Michael Rubino specializes in working with teenagers, their parents and high schools.  For more information on his work visit his website www.rubinocounseling.com or follow him on Twitter @RubinoTherapy.

Parents are Important Role Models

High school and the teenage years are a very difficult time for many teens and parents. This time of life has become even more difficult with the advancement of social media, a majority of children over 12 years old having smart phones and computer technology not to mention the increase in drugs that are currently available to teens. Teens have access to designer drugs such as ecstasy, spice and pink as well as prescription drugs such as Vicodin or Concerta can easily be obtained on any middle school or high school campus today. And yes, this is the true. These drugs are available on middle school campuses.  Furthermore, the current state of politics in our country has made life more difficult for parents. It is hard to ask your teenager to be respectful of others when they see the leaders of our nation being disrespectful to people.

Our society is advancing and changing so fast that life is becoming overwhelming and confusing for teenagers and for parents too. One thing that has not changed is that parents are a child's main role models for life.  However, many parents have forgotten that they are their teenagers primary role models.  Many parents have also forgotten that they can tell their teenagers no.  They do not have to buy their teenager the latest smart phone or the latest fashion.

I have many parents tell me that they do not feel respected by their children in middle school or teenagers.  However, very often, parents don't require teenagers to be respectful.  Many parents may set rules and their teenager blatantly ignore their parents and their are no consequences.  Parents tell me this often and I suggest suspending their teenager's phone service or not taking them on family trips.  Many parents looked at me and say they cannot do that to their teenager.  Their teen relies on their cellphone or have been counting on a certain family trip.  Parents also tell me if they take such actions their teen will become very difficult to live with and might break things in the house.

So who is in charge? Your teenager is in charge. Remember they know you very well.  They know you will be anxious or feel guilty about imposing tough consequences.  Therefore, they are not afraid to disrespect you and do what they want because they know there will be little to no consequences.

Therefore parents if you want respect, don't be afraid to impose consequences. Remember your teenager needs you to pay their bills and give them consent to get a drivers license.  Parents you have more power than you realize. Also if you don't expect respect and allow disrespect that is what you are going to get.

Many times I have explained to the teens I work with how much their parents do for them.  I then ask what would happen if mom and dad stop doing all these things?  Teenagers always stop and think at this point.  If the teen still chooses to test the limits with their parents, as soon as they see mom and dad will stand by what they say, they soon learn to respect mom and dad.  Parents you must remember to only set limits that you are willing to follow through with and impose.  If you don't impose the limits you have set, your teenager will not respect your word or authority.

Parents it is also important to remember that you cannot just start teaching your child about respect when your child turns 13 or 15 years old.  By this point in their life, you have established patterns of disrespect.  You need to start setting limits and taking to your children about respect when they are one or two years old.  This way it is a concept they grow up with through their lives.  It is a process that takes time.  It is important that you remember this fact.

Besides discussing respecting their parents it is important that you also talk about respecting authority figures such as grandparents, police and teachers.  It is also important that you talk about respecting themselves.  Remind them they are special and worthy of being treated nicely by other people.  It is important that you educate your child and teenager that no one has a right to use them or make them feel bad about themselves. They need you to remind them that they are important and no one has a right to disrespect them either.

Remember, since your child was born, they have been watching you and studying you about how to act and what actions are appropriate and what is inappropriate. They have been listening to what you have been saying to them about how to act as a responsible, decent member of society. I know many parents feel that once their child started middle school that their child stopped listening to them, but that is not true. They may act like they are not listening or that they don't care about your opinion, but they do.

I have teenagers come into my office all the time and complain that they feel like their parents do not care about what they do. Often teenagers make this assumption because they say their parents set no boundaries for them or they feel that the parent cares more about their careers than their children. At times parents do focus more on careers or stop setting limits because they feel that their child doesn't listen to them. Parents often feel this way because their teenager will say, "I don't care what you think or I don't care what you do". However, they do care and often they say these things or act this way because they feel hurt.

Every child, no matter what they say, wants to know that they are important to you, that you care about what they say and you care about what they do. One major problem that I encounter with parents is that many parents do not practice what they preach. Yes you are an adult and you have a right to drink alcohol or engage in other adult behaviors, but you need to do so responsibly. Therefore, if you drink alcohol, do so responsibly.  Also watch how you speak to your teen and others. Do you do so in a respectful manner or are you rude to people?

A lot of parents will come in and tell me that their behavior doesn't matter and that their child has no idea what they do so they can do what they want. The truth is, your behavior does matter and your children know what you are doing even if you think they do not know.

I have had eight year old children complain that "my mommy drinks too much wine", or "my daddy smokes pot in the garage" or "my daddy talks mean to people", or "my parents fight too much.". When I try to talk to a teen about their behavior after they have said something like this, the teen responds if my parents can do it, why can't I? This is difficult to argue with if the parents are using illegal drugs or abusing alcohol. Also the fact that eight year old children also make these comments demonstrate that if you want your teen to act respectful, then as a parent you need to model respectful behavior starting when they are born. Also children want to know that they are important to you and setting rules and enforcing rules communicate to your children that you care about them.

The bottom line is that as a parent you have the most significant role in your child's life. If you want your child to grow up to be a mature, responsible adult, then you have to act like a mature, responsible adult and you need to do so from the day they are born.

In this world where things are changing over night, children need to know they can rely on their parents to protect them and guide them. Again given how fast society is changing, this is not an easy job for a parent. The easiest way to sum it up is to remember to practice what you preach.

Dr Michael Rubino has over 20 years experience working with teenagers and their parents. Dr Rubino is considered an expert in this area. For more information on Dr Michael Rubino and his private practice visit his website at www.rcs-ca.com or Facebook page at facebook.com/Drrubino3.

I Have A Teenager and I'm Stressed

I often hear for the teenagers that I see for psychotherapy how stressful it is to be a teenager. I hear about difficulties with school and parents.  However, being the parent of a teenager is stressful for parents too.  Parents also have to deal with school issues and other teen issues.

One on the first concerns parents face is the fact that their child is going to have more exposure to alcohol, drugs and sex.  Many parents I talk to are shocked at the drugs high school kids are using today.  Heroin is now common on high school campuses and parents are shocked. They are also shocked that middle schools are passing out condoms.  They cannot believe how sexually active some teenagers are and how teens think about sex.

So what should parents do?  Parents need to educate themselves about drug and alcohol use on high school campuses and about sexual activity rates for teenagers.  After educating themselves then parents need to talk with their teenagers.  Explain the risks associated with alcohol, drugs and sex.  Also explain how to protect themselves if they decide to engage in any of these activities.  This is not giving your teen permission, but you cannot control their decisions.  If they decide to use drugs, you want them to be safe.  Also explain your opinions about if you think they are ready for these issues or not.  You do not want to preach, but it is important that your teenager is aware of your expectations.  You cannot control their decisions, but you do not have to approve of their choices.  This is something your teenager needs to understand. If they feel they are old enough to make these choices, then they are old enough to deal with your reactions.

Another major stress for parents is curfew.  This is a common argument I hear in my office.  As high school is starting you need to sit down with your teenager and agree on a curfew time.  Ask find out what time curfew is for your city.  It is not asking too much that your teenager is home at a decent hour.  For Freshman, 11pm really is a realistic time.  When you discuss curfew I suggest a contract where you specify the time and consequences for breaking curfew.  If you have it in writing, if there is a disagreement you can settle it easily by referring to your contract.

Another major concern for parents is driving.  Parents worry about who will be driving and how well do the drive. The other concern is the driver driving drunk or high. Parents worry about getting a call in the middle of the night that there was a car accident and there child is in the Emergency Room.  With the recent changes in driving laws they decrease the chances of teen accidents.  However, they do not stop teenage driving accidents.  As parents you need to again sit down and discuss your concerns and agree on a contract.  Agree about who they can drive with, who they cannot and keeping you informed.  Again agree on consequences and write out a contract to decrease arguments.

Another major stressor for parents is money.  Your teen wants to go out with friends and they need money for food, Starbucks or going to a movie.  Parents also have to deal with the bills if your teen wants to play a sport or play an instrument or be a cheerleader.  Parents have to pay for uniforms and a wide range of extras. Plus parents have to drive their teen to and from practices and games.  Some sports such as football, there is practice daily.

These are only a few issues parents face when their child starts high school.  They have to adjust to these and the fact that their child is getting older and is no longer a little kid.  They are now young adults.  We expect parents to adjust to all of these changes over night.  Just like we need to give teenagers time to adjust to being in high school, we need to give parents time to adjust to having a child in high school. We also need to understand that parents will make mistakes during and after this adjustment period.

Parents you need to remember that you are going through a big adjustment just like your teenager.  Also just like your teenager you need to allow yourself time to adjust and accept that you will make mistakes.  You need to be patient and kind to yourself.  Also if your teen is getting frustrated with you, do not be afraid to mention that you are going through an adjustment period too and they need to be patient with you.

Dr. Michael Rubino has worked with teenagers and their families for over 20 years.  If you would like more information on Dr. Michael Rubino's work or his private practice visit his website www.rubinocounseling.com or his Facebook page facebook.com/drrubino3.

Teenage Drug Abuse and Suicide Rates

Many teens die from suicide and drug abuse. Suicide is the third leading cause of deaths for children 10 to 24 years old.  One thing that contributes to teenage suicide is drug use.  Specifically, the use of pain killers and heroin.  In this article I attempt to describe both issues for parents.  It is important for parents to be aware of these issues if we are going to stop them.

ABC 20/20 did a very good show the other night about the epidemic of heroin use in the United States.  If you did not see it, you can probably find it on their website. Parents this is a show you need to see because many teenagers I work with are not afraid or concerned about how dangerous heroin can be.

According to ABC 20/20, 129 people die every year from a heroin overdose. A majority of these deaths are teens and people in their twenties.  Heroin is used by people in the lower income level and by people who are the wealthiest in the country. It is used by whites, blacks, Hispanics basically every ethnic group. It is also used by males and females. Therefore, for the families in Lafayette, Walnut Creek and Danville who say we don't have that problem here, yes you do. Also for parents and educators who think that if their child is in a private school they are less likely to use, you are wrong too. Heroin crosses all ethnic and economic boundaries. The epidemic is so severe some schools are teaching children in the 6th grade how to use Narcan. This drug can reverse an overdose of heroin if administered in time.

Therefore, parents in the Bay Area, you need to pay attention to this issue and these facts. You might be saving the life of your child or someone else you love.

As stated Heroin use to to be a drug of the past but it is now very popular with teens. Heroin is a cheaper alternative to many other drugs. For $10 a teenager can buy a capsule of heroin. This is much cheaper than other drugs.

Heroin is still mainly snorted or injected. Because it is injected teens are exposing themselves to HIV and Hepatitis C. Both are life threatening conditions with no cure. Also many girls who use heroin get pregnant but don't realize they are pregnant until the 4th or 5th month. The girls stop but it is too late. The babies will be born drug addicted and if they live through withdrawals, these children will have on going health issues and learning disabilities. In addition to exposing themselves to diseases most teens use Heroin with other drugs such as alcohol. This makes the probability of overdosing on Heroin even higher. Heroin lowers a persons breathing rate and the drugs they are combining it with lower the breathing rate even more making an accidental over dose more likely. The rate of overdosing from Heroin has quadrupled over the years.

Why is Heroin coming back and very popular with teens? Heroin is very similar to the Opioid based pain killers that teens have been using for years. However, with the cost of pain killers rising on the streets and becoming harder to get due to new prescription laws, heroin is easier to get and cheaper. Also teens tend to like the high better. It is not uncommon for someone to get addicted after using heroin one time.

In the last few years heroin use has doubled in teenagers. What teens are at the highest risk? Those who have been using Opioid pain killers, those abusing marijuana and males.  Remember it is very common for teens to combine heroin with other drugs and they are unaware of the impact it has on their breathing. They may collapse and not know why and by the time their friends get them to an emergency room it's too late. Also teens may go to sleep after using and their breathing rate is so shallow they never wake up.

This is a very dangerous drug. If it doesn't kill when the teen uses it the drug can kill when the teen contracts HIV or Hepatitis C. The rate of teens using this drug has doubled and the amount of people dying from an overdose has quadrupled over the last few years.  Again, parents you cannot ignore this issue. Heroin is being used by upper class children and poor children, athletes, and all races. So it is impacting all teens.

The other major issue with this drug is stopping. Someone cannot just go off heroin. People can die from withdraw.  However, finding a treatment center that is affordable or with an open space is very difficult.  They may have to wait four months to get into a rehab center.  This is very dangerous.  When someone decides to stop heroin, they need to enter rehab immediately.  If they have to wait even 2 days, they may not make it because they cannot stand the withdrawal symptoms.

If we get involved we can hopefully stop teens from using this highly addictive killer. I have attached a link to a handout by the CDC with facts, warning signs and suggestions to help your son if you think he is using heroin.   http://www.cdc.gov/vitalsigns/heroin/
http://www.cdc.gov/vitalsigns/heroin/

In addition to these issues, Heroin and drug abuse is linked to teenage suicide.  These drugs besides creating a high, create depression. At times a depression so severe that a teenager decides they would be better off dead and they commit suicide.  For the age group 10 to 24 years old, suicide is the third leading cause of death. Therefore, we need to pay attention to the pain killers and other drugs kids are using. And yes 10 year old kids are using these drugs too.

Many times the teen has decided they want to get clean and stop using the drug. However, as I mentioned above, finding an affordable treatment program with an open bed can be very difficult. Some teenagers may need to wait 2 months.  This can be two months two long.  The teenager may be so depressed and tired of living the drug life that they decide to kill themselves rather than endure the emotional and physical pain of waiting two months.

Another point is for some teenagers they have to try four or five times in rehab before they are successful. Again most teenagers are usually dealing with severe depression at this point. For them the thought of trying again and not succeeding is to much to tolerate. Therefore, they chose the option of suicide to eliminate their pain.

Finally, I mentioned a number of teenagers can overdose by accident, however it may not be an accident. These teens know these drugs very well so they know how to stage what will look like an accidental overdose.  Therefore, we really don't know how many teenagers are committing suicide due to being sick and tired of using drugs and living a drug life.  Many of the accidental overdosages could really be suicides. There is no way to tell.

What we know is drug use and suicide are at an epidemic rate for teenagers.  It is at a point where we need to get aggressive and provide better access to rehabilitation programs and better access to psychotherapy so the depression can be treated.  We need a multi-disciplinary approach to this issue and we need to make it easy for teenagers and parents to use it.

Dr. Michael Rubino is a psychotherapist who has been working with teens for over 20 years and he is considered an expert in this field. For more information about Dr. Michael Rubino and his private practice visit his website at www.rubinocounseling.com or his Facebook page at www.Facebook.com/DrRubino3.